Healthcare Provider Details

I. General information

NPI: 1720208937
Provider Name (Legal Business Name): JUDITH CARRIE CRAIG R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 08/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15550 N PARKVIEW PL
SURPRISE AZ
85374-7465
US

IV. Provider business mailing address

27760 N. 130TH AVE
PEORIA AZ
85383
US

V. Phone/Fax

Practice location:
  • Phone: 623-523-8840
  • Fax: 623-523-8811
Mailing address:
  • Phone: 623-523-8840
  • Fax: 623-523-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN102494
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: